Digital Commons Network^™

Modeling Of Transformation Temperatures In Cast Martensitic Stainless Steels-Ca6nm: Effects Of Composition, Heating Rate, And Grain Size, Ugochukwu Agbedo, Mario Buchely, Laura Bartlett, Caelan Kennedy

Materials Science and Engineering Faculty Research & Creative Works

Accurate prediction of the critical transformation temperatures Ac1 and Ac3 is one of the essential factors in the heat treatment of CA6NM cast martensitic stainless steel. In this study, the influence of alloy composition, heating rate, and prior austenite grain size on the critical temperatures was quantified using dilatometric measurements and statistical modeling. Six heat treatment conditions produced prior austenite grain sizes ranging from ~75 to 247 µm. Experimental results showed that grain size variations produced only minor changes in Ac1 and Ac3, indicating a weak dependence of transformation temperatures on prior austenite grain size within the investigated range. In …

Multiphysics Simulation And Experimental Validation Of Phase Transformation And Hardness In Jominy End-Quenched Low-Alloy Steels, J. S. Alabi, E. Heidari, M. F. Buchely, K. Chandrashekhara, S. N. Lekakh, R. J. O'Malley, V. A. Athavale, A. Kumar

Materials Science and Engineering Faculty Research & Creative Works

High-volume industrial continuous hot-rolled steel heat treatment processes involve sophisticated multi-phase modeling. The performance of a given process can be optimized by coupling phase transformation kinetics with the cooling conditions of the process. This study develops a multiphysics model to simulate an intensive quenching process for steel, which is inherently transient and highly dependent on numerous parameters. The simulated object was a Jominy end-quenched specimen geometry using two commercial steels, AISI 4130 and AISI 4140, with the goal of transferring a verified methodology to the heat treatment process for industrial heavy-section products (bars, slabs). The simulation employs thermal, mechanical, and …

Disability And Accessibility In The Voice Studio: An Open Educational Resource, Katherine Meizel, Anne Slovin

Open Educational Resources

No abstract provided.

Shunk Papers, Harold W., Sdsu Archives And Special Collections, Hilton M. Briggs Library

Archives Finding Aids

The Harold W. Shunk Papers document the career and historical interests of an educator, public servant, and historian active in South Dakota during the mid to late twentieth century. The collection focuses on Native American history, particularly the Dakota and Lakota tribes, and includes newsletters, manuscripts, notebooks, transcripts, and historical lists. Prominent materials include Wahehe Heirship hearing transcripts, personal histories connected to the Cheyenne River Indian Reservation, writings on the Dakota tiospaye system, and documentation related to military posts such as Fort Laramie and Fort Totten. The papers also address significant historical events and individuals, including Wounded Knee and tribal …

A Constructivist Grounded Study: At The Intersection Of Religion And Intimate Partner Violence In The Context Of An Ultra-Orthodox Jewish Community, Lauren Kalvari

Theses and Dissertations (Comprehensive)

This constructivist grounded theory study, informed by a critical intersectional lens and guided by symbolic interactionist theory, explored how Ultra-Orthodox Jewish women experience and navigate intimate partner violence (IPV) within their religious and community contexts. Ten participants, recruited through purposive and theoretical sampling, were separated or divorced from abusive partners for at least eight months and had engaged in psychotherapy, allowing for retrospective meaning-making. Each participant completed one to three in-depth interviews on IPV, community responses, spiritual conflict, and recovery. Data collection and analysis were conducted concurrently using Charmaz’s iterative constructivist grounded theory approach, which included initial, focused, and theoretical …

Exploring The Role Of Cognitive Load In Applicant Faking And Prevention Methods, Sabah Rasheed

Theses and Dissertations (Comprehensive)

Personnel selection is critical to organizational success, and personality assessment is widely used to identify the best job candidates. However, applicant faking threatens the validity of personality assessments in high-stakes contexts. Faking is widely assumed to be more cognitively demanding than honest responding, and several faking-prevention methods rest on this premise. This dissertation examines that assumption across three studies using the dual-task paradigm to impose cognitive demands during personality assessments. Study 1 used a verbal digit-span task with a student sample and limited faking on the three job-relevant personality composites. Study 2 used a visual dual-task with a student sample …

Neural Correlates Of Cognitive Fatigue In Regular Cannabis Users And Non-Users: A Pilot Fnirs Study, Mariia Vistyzenko

Theses and Dissertations (Comprehensive)

Background: Cognitive fatigue impairs performance across multiple domains, yet how regular cannabis use affects fatigue responses remains unclear. This pilot study investigated neural and behavioural correlates of cognitive fatigue in abstinent cannabis users versus non-users.

Methods: Twenty-six participants (18 non-users, 8 regular cannabis users after 24-hour abstinence) completed cognitive tasks before and after a 60-minute Sustained Attention to Response Task (SART) designed to induce fatigue. Tasks assessed working memory (N-Back), cognitive flexibility (Wisconsin Card Sorting), psychomotor speed (Digit Symbol Substitution), sustained attention (Continuous Performance Task), inhibition (Stroop, Stop Signal), and motion perception. Functional near-infrared spectroscopy (fNIRS) continuously monitored prefrontal cortex …

Children's Peer Selection In Stem: The Influence Of Gender, Ethnicity, And Disability, Meagan Girard, Kim P. Roberts

Theses and Dissertations (Comprehensive)

The present study examined how children’s peer selection in STEM (science, technology, engineering, and mathematics) may be influenced by gender, ethnicity, and physical disability. Sixty-four children (ages 6-12) from elementary schools in Southwestern Ontario completed three tasks: a simulated peer selection task, an attribution of ability task, and a stereotype belief questionnaire. In the peer selection task, participants were repeatedly asked to select one peer from a set of AI-generated photographs showing children who differed by gender (male, female), ethnicity (White, Black, East Asian), and physical disability status (able-bodied user vs. nondisabled). The Peer Selection Task was based on the …

Exploring Leadership In A Changing Church, Tanya Varner

Theses and Dissertations (Comprehensive)

The present phenomenological study investigated the experience of leaders and leadership among active Lutheran clergy serving congregations in the Eastern Synod of the ELCIC in a time of change. Eleven rostered leaders of the Eastern Synod of the Evangelical Lutheran Church in Canada (ELCIC) were interviewed individually using a semi-structured interviews addressing leadership and changes in the church to facilitate the conversation. Participants also completed a participant questionnaire in advance of the semi-structured interview to make sure the sample was diverse in gender, years of ordination and geographical context of ministry. Participants were able to articulate what values and requirements …

" Who Am I Here?" Exploring The Racial Identity Development Of Chinese Adolescent International Students In Canada: A Constructivist Grounded Theory Approach, Wen Juan Song

Theses and Dissertations (Comprehensive)

Abstract

This dissertation explores the racial identity development and associated mental health challenges of Chinese Adolescent International Students (CAIS) in Canada, a population navigating complex intersections of race, age, migration, and belonging. Despite their growing presence in Canadian secondary education, CAIS remain understudied in both educational and mental health research, particularly in relation to racial identity development within Western, multicultural societies. Using a Constructivist Grounded Theory methodology, this study draws on in-depth interviews with twenty-five CAIS participants, including ten current high school students, three returnees to China, and twelve who remained abroad in post-secondary education or employment.  The study is …

Mediating Effect Of Social Determinants Of Health Between Race And Phthalate Biomarkers In Pregnancy, Tetsuya Kawakita, Misa Hayasaka, Carole Barake, Trinity Soto, Jillian Fleming, Amir Lueth, Stevens Danielle, Alfred Abuhamad, Ann Pryzybylska, Elena Sinkovskaya, Kelly K. Ferguson, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Introduction

Prenatal phthalate exposure is linked to adverse reproductive and developmental outcomes and is consistently higher among non‐Hispanic Black compared to non‐Hispanic White pregnant individuals, yet the factors responsible for these disparities are poorly characterized. We sought to quantify Black–White differences in repeated urinary concentrations of phthalate biomarkers during pregnancy and to estimate the extent to which neighborhood‐level social determinants of health (SDoH) mediate these disparities.

Methods

This secondary analysis used data from the Human Placenta Project Study, a prospective observational cohort study conducted at two academic institutions between 2016 and 2018. Eligible participants had singleton pregnancies, were recruited before …

Hungarian Validation Of The Pelvic Floor Distress Inventory - 20 (Pfdi-20) Questionnaire And The Pelvic Floor Impact Questionnaire - 7 (Pfiq - 7), Barbara Kozma, Bence Kozma, Peter Takacs, Dávid Rátonyi, Nelli Farkas, Attila G. Sipos, Balint Farkas

Department of Obstetrics & Gynecology Faculty Publications

Introduction and Hypotheses

Pelvic floor disorders (PFDs) affect women's quality of life through physical, psychological, and social domains. The Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) are validated tools for assessing symptom severity and quality of life impact. The current study aim to investigate the reliability and validity of the Hungarian versions of these questionnaires in women with PFD symptoms.

Methods

This validation study was carried out at the University of Debrecen among women with clinically confirmed pelvic floor disorders. The PFDI-20 and PFIQ-7 questionnaires were translated into Hungarian using independent native English speaker in …

The Association Between The Degree Of Social Vulnerability And Maternal Anemia And Other Adverse Perinatal Outcomes, Rubymel J. Knupp, Christina T. Blanchard, Ariann Nassel, Ashley Shea, Lindsay S. Robbins, Jeff M. Szychowski, Ashley N. Battarbee, Akila Subramaniam

Department of Obstetrics & Gynecology Faculty Publications

Objective

Maternal anemia in pregnancy is associated with many adverse maternal, fetal, and neonatal outcomes. The role of social determinants of health (SDOH) in the development of maternal anemia and other adverse outcomes is continually evolving. One such newer tool, the Social Vulnerability Index (SVI), measures an individual's community-level SDOH, with higher SVI denoting higher vulnerability. Our objective was to evaluate the association between SVI, maternal anemia, and other adverse perinatal outcomes.

Methods

Retrospective cohort study of pregnant individuals delivering singletons at a gestational age ≥23 weeks at a single center from 2014 to 2018. Patients with sickle cell disease, …

The Association Between Social Vulnerability And Racial Disparities In Preterm Birth, Anita Pershad, Gabby Adams, Lindsay Robbins, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the association between county-level social vulnerability and preterm birth and assess whether racial disparities vary across levels of vulnerability.

Methods

This cross-sectional study utilized restricted Centers for Disease Control and Prevention natality data from 2023. We included Black or White births with singleton pregnancies across 3123 US counties from 50 US states and the District of Columbia. Participants were grouped into quartiles based on the county-level Social Vulnerability Index (SVI), with quartile 4 representing the most socially vulnerable populations. The primary outcome was preterm birth, defined as delivery before 37 weeks. Secondary outcomes included small for gestational …

Applications And Challenges Of Utilizing Digital Pathology And Ai-Enabled Workflows In Clinical Trials, Manu Sebastian, Harsh Batra, Monika Lamba Saini, Staci Kearney, Lorcan Sherry, Serge Alexanian, Michael Cohen, William Weber, Joe Lennerz, Anil V Parwani

Faculty, Staff and Student Publications

This is a comprehensive review on current utilization and challenges of digital pathology adoption in clinical trials and aims to provide a broad view on its impact on pathology review processes in clinical trials. It provides an overview of current pathology review practices in clinical trials and unique advantages digital pathology adoption can offer. The key areas including existing workflows, use case scenarios in different disease areas in clinical trials, including but not limited to patient identification and pre-screening, and regulatory aspects have been described with relevance. In addition, the review delves into the integration of genomics, AI, image analysis, …

Blood Flow Regulates Metabolism In Hematopoietic Development, Pamela L Wenzel

Faculty, Staff and Student Publications

Blood flow modifies oxygen availability and biomechanical forces within the vasculature of the embryo as the hematopoietic system develops. The aorta-gonad-mesonephros (AGM) envelops the largest artery in the body and is a critical site for the emergence of hematopoietic stem cells (HSCs). Herein, I discuss the role of hypoxia-inducible factors (HIFs) and force as determinants of metabolism and fate determination. To address the effects of blood flow on hematopoietic development, I employ mouse embryo models and biomimetic culture. Real-time cell metabolic analyses show that oxygen consumption rates (OCR) and extracellular acidification rates (ECAR) are altered by flow in cultures of …

Host Modulation Therapy In Periodontitis: From Established Therapies To Emerging Technologies, Aonjittra Phanrungsuwan, Jiaqi Huang, Neeraja Dharmaraj, Alejandra Cobos Perez, Omid Veiseh, Simon Young, Chun-Teh Lee

Faculty, Staff and Student Publications

Periodontitis is a biofilm-induced chronic inflammatory disease, characterized by gingival inflammation and alveolar bone loss. According to a national survey, approximately half of the U.S. adults are affected by periodontal disease. To effectively prevent and treat periodontitis, it is essential to address its underlying causes. The primary etiological factors include polymicrobial synergy and dysbiosis of the oral microbiota, and a dysregulated immune response. The standard therapeutic approach, mechanical removal of biofilm through debridement, sometimes demonstrates limited efficacy, particularly in cases of severe periodontitis, which may require adjunctive or additional therapy. Emerging evidence indicates that periodontal tissue destruction is initiated by …

Nampt Inhibition Uncovers Therapeutic Vulnerabilities To Venetoclax And Chemotherapy In Acute Myelogenous Leukemia, John R Sanchez, Chaomei Liu, Vishakha Pawar, Yanqing Huang, Daisy Diaz-Rohena, Jyotsana Singh, Priya Koppikar, Tzung-Huei Lai, Lisa St John, Vinay Puduvalli, Jeffrey Molldrem, Palaniraja Thandapani, Nitin Jain, Rosa Lapalombella, Deepa Sampath

Faculty, Staff and Student Publications

Acute myeloid leukemia (AML) cells depend on nicotinamide adenine dinucleotide (NAD

Integrative Multi-Omics Profiling Identifies Infiltrative Hepatocellular Carcinoma As An Immunotherapy-Resistant Subtype With Distinct Molecular Features, Won Suk Lee, Seonjeong Woo, Sung Hwan Lee, Gae Hoon Jo, Ilhwan Kim, Hyeyeong Kim, Chansik An, Sanghoon Jung, Gwangil Kim, Haeyoun Kang, Beodeul Kang, Jung Sun Kim, Ho Yeong Lim, Incheon Kang, Hannah Yang, So Jung Kong, Dahyeon Son, Dong Jun Shin, Woo Young Kwon, Da-Yeon Lee, Ju-Seog Lee, Junho Park, Youngsoo Kim, Sohyun Hwang, Chan Kim, Hong Jae Chon

Faculty, Staff and Student Publications

Background/aims: Hepatocellular carcinoma (HCC) exhibits substantial morphological and biological heterogeneity. Clinical and molecular relevance of the infiltrative subtype remains poorly defined in the context of cancer immunotherapy. We aimed to evaluate the prognostic impact and molecular features of infiltrative HCC in patients treated with first-line atezolizumab plus bevacizumab (Ate/Bev).

Methods: We included 307 patients with advanced HCC treated with Ate/Bev and classified them into four gross morphological types based on imaging. Multi-omics profiling was conducted on tumor samples. Type IV infiltrative signature was derived and externally validated using five independent HCC cohorts, including IMbrave150.

Results: Infiltrative morphology, encompassing pure and …

Milner Library Annual Report, 2026, Milner Library, Illinois State University

Reports and White Papers - Milner Library

2025 annual report for Milner Library, Illinois State University.

Dietetic Guidance For Nutritional Management Of People With Phenylketonuria Receiving Sepiapterin, Anita Macdonald, Kirsten Ahring, Alexa Bledsoe, Hiroki Fujimoto, Sara Giorda, Christian Kogelmann, Jessica Kopesky, Laura Nagy, Sara O'Neill, Alex Pinto, Soraia Poloni, Paige Roberts, Annemiek M J Van Wegberg, Suzanne Hollander

Faculty, Staff and Student Publications

Background/objectives: Phenylketonuria (PKU) is an autosomal recessive inborn error of metabolism. If untreated, elevated blood phenylalanine (Phe) levels lead to neurological and behavioral impairments. Phe levels can be managed through a lifelong Phe-restricted diet; however, this can be challenging to maintain. Sepiapterin is an adjunct therapy for PKU that has shown efficacy in reducing blood Phe levels in both tetrahydrobiopterin (BH4)-responsive and BH4-non-responsive people with PKU in clinical trials. Practical guidance is needed for dietitians and other healthcare professionals supporting the dietary management of people with PKU who are initiating or receiving sepiapterin.

Methods: A group of international dietitians participated …

Memory Warriors, Pluralists, And Abnegators In Constitutional Interpretation: An Essay On Jack Balkin's Pluralist Originalism In Memory And Authority, Jed Handelsman Shugerman, Zachary Shugerman Handelsman

Faculty Scholarship

Jack Balkin’s Memory and Authority: The Uses of History in Constitutional Interpretation brings into conversation the scholarly insights of constitutional theory, history, and the growing field of “the politics of memory,” especially the concept of the “memory entrepreneur.”

Balkin appropriately connects the memory wars in American constitutional law back to Eastern

European memory wars during the World Wars and their aftermath. Prompted by Balkin, we turn to Jan Kubik and Michael Bernhard edited volume Twenty Years After Communism (2014), which has become even more widely influential after Putin’s invasion of Ukraine and a new round of Eastern European memory wars. …

From The Goodness Of Our Hearts: A Scoping Review Of Qualitative Literature On Altruism As A Reward Mechanism For Nursing, Jacqueline Christianson, Madaline Mccarthy, Bonnie Sommers-Olson, Emily Horner, Norah L. Johnson

College of Nursing Faculty Research and Publications

Introduction

Altruism, the desire to help others, is a common motivation for choosing a career in nursing. Improved understanding of the role of altruism as a reward or motivation for currently-practicing nurses may inform future interventions to improve effort-reward balance among practicing nurses. Therefore, the purpose of this study was to collect, examine, and present literature on how altruism has been described as a reward mechanism or motivation for engaging in professional nursing.

Methods

This scoping review of literature used the Arksey & O’Malley method, PRISMA-ScR reporting checklist, and Rayyan review management platform. PubMed, Web of Science, and CINAHL were …

Ultra-Processed Foods And The Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, And Translational Evidence, Saiful Singar, Amirhossein Ataei Kachouei, Leandro Lantigua-Somoano, David Manley, Anthony Cardinale, Muhammad Zulfiqah Sadikan, Saurabh Kadyan, Donya Shahamati, Lorena Dias, Amber Wood, Cinthia Chavarria, Sara K. Rosenkranz, Neda S. Akhavan

Department of Medicine Faculty Publications

Cardiovascular-kidney-metabolic (CKM) syndrome integrates excess adiposity, metabolic dysfunction, kidney impairment, subclinical cardiovascular diseases, and clinical events along a staged continuum that invites unified prevention and treatment. Ultra-processed foods (UPFs) are a complex, high-prevalence exposure that may influence risk across CKM stages through nutrient profiles, additives, processing-induced compounds, and packaging-related contaminants. This review synthesizes epidemiologic, mechanistic, and translational evidence with attention to exposure definition and analytic rigor. We summarize NOVA-based UPF operationalization across dietary assessment tools, highlighting misclassification of mixed dishes, brand heterogeneity, and energy under-reporting, and we propose further examination of energy-adjusted models, calibration, and harmonized metrics. Observational studies consistently …

Insurance Disparities In Hidradenitis Suppurativa: A Comprehensive Review Of Demographics, Outcomes, And Access To Care, Alim Osman, Alexandra R. Nigro, Michael C. Povelaitis, Marc Z. Handler

Department of Medicine Faculty Publications

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that disproportionately affects women, African Americans, and individuals of biracial descent. It is associated with substantial physical and psychiatric morbidity, reducing quality of life.

Objective: This review analyzed disparities in treatment outcomes, disease progression, and healthcare access among HS patients based on insurance type.

Methods: Using PRISMA guidelines, a comprehensive literature search identified 7 studies meeting inclusion criteria. Owing to data heterogeneity, studies were qualitatively analyzed.

Results: Findings consistently demonstrated that Medicaid patients experienced worse outcomes than those with private insurance or Medicare. Medicaid patients had higher rates of comorbid …

The Effects Of Membrane Structure And Filtration Conditions On Virus Filtration, Wenbo Xu, Xianghong Qian, Hironobu Shirataki, Daniel Strauss, Sumith R. Wickramasinghe

Biomedical Engineering Faculty Publications and Presentations

Virus filtration is used for validation of virus clearance in the manufacture of monoclonal antibodies. Requirements for this size exclusion process include 10,000-fold reduction of virus particles and at least 95 % recovery of the monoclonal antibody in the permeate. The size difference between the rejected parvovirus particles, 25 nm, and monoclonal antibody, 10-12 nm, is about two. Membranes are designed with pore sizes around the average size of the parvovirus. Given the polydispersity in membrane pore size and virus particles, filter performance is dependent on membrane properties, feed and operating conditions. Compromised performance usually occurs due to product related …

Contralateral Breast Cancer After Radiotherapy And Hormone Therapy In Two Cohorts Of Us Breast Cancer Survivors, Lene H S Veiga, Gretchen L Gierach, Susan A Smith, Rebecca M Howell, Matthew M Mille, Monjoy Saha, Rochelle E Curtis, Cody Ramin, Clara Bodelon, Heather Spencer Feigelson, Erin J Aiello Bowles, Diana S M Buist, Sheila Weinmann, Jacqueline B Vo, Choonsik Lee, Amy Berrington De Gonzalez

Faculty, Staff and Student Publications

Background: Radiotherapy increases contralateral breast cancer risk, while hormone therapy reduces it; their combined effects are unclear.

Methods: Data from two US retrospective cohort studies of 5-year breast cancer survivors (stage I-III, ages 20-84), Kaiser Permanente (KP, 1990-2012) and SEER (1990-2013), were analysed. Contralateral breast radiation doses were estimated for the KP cohort. Multivariable Poisson regression estimated relative risks (RRs) and excess relative risks per Gray (ERR/Gy), stratified by hormone therapy use.

Results: KP cohort (n = 9053) included 353 contralateral breast cancer cases (73% ER+); SEER cohort (n = 244,834) included 10,470 cases (72% ER+). Among women with ER+ …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

Characteristics Of Women Who Fast During Pregnancy: Findings From The Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Reem Al Sabah, Ahmed N. Albatineh, James Blando, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Fasting during pregnancy is a widespread practice in Muslim communities, yet its health implications remain poorly understood. A lack of conceptual frameworks and limited understanding of the characteristics of women who fast during pregnancy have hindered research in this area. This study examines the differences in several nutritional biomarkers between women who fasted and those who did not and identifies factors associated with fasting behaviour. We analysed data from the Kuwait Birth Cohort in which information on fasting, sociodemographic characteristics and health behaviours was collected via structured interviews between 2017 and 2021. Clinical and laboratory data were extracted from medical …

Prevalence Of Dengue Infection In Bangladesh: A Systematic Review And Meta-Analysis, Md. Estiar Rahman, Abdullah Al-Taiar, May Salama, Michele A. Kekeh, Ahmed N. Albatineh

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective: 

To estimate the pooled prevalence of dengue infection in Bangladesh.

Methods:

Literature search was conducted across PubMed, Web of Science, and Hinari between December 2024 and April 2025, supplemented by references searching. The Joanna Briggs Institute checklist was used for evaluating study quality. A random effects meta-analysis of proportion, including subgroup analyses, was performed with R software (version 4.5.1).

Results:

Out of 2 087 records, 28 studies were included. The pooled prevalence of confirmed dengue infection among clinically suspected patients was 49.3% (95% Cl 36.1-62.6), with a significant high heterogeneity (I²=99.2%, τ²=1.81, P< 0.001). Stratified analysis showed a pooled prevalence of 47.9% (95% Cl 34.0-62.2, I2=99.1%, …